Qiaoli Hua a, Lijuan Tang a b, Jingwei Shui b, Yuntao Liu b c, Ge Zhang d, Xiaohua Xu b c, Chunyuan Yang e, Wenjian Gao f, Guocheng Liao g, Qingming Liu h, Huilin Liang i, Qingkun Mo j, Fangxiu Liang k, Jianwen Guo c l m, Zhongde Zhang b c l

 

a

The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510006, China

b

Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China

c

Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China

d

Development Research Center of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China

e

Yangshuo County Centre for Disease Control and Prevention, 541900, China

f

Yangshuo County Hospital of Traditional Chinese Medicine, 541900, China

g

Yangshuo County Baisha Township Hospital, 541900, China

h

Yangshuo County Fuli Township Hospital, 541000, China

i

Yangshuo County Gaotian Township Hospital, 541000, China

j

Yangshuo County Puyi Township Hospital, 541000, China

k

Yangshuo County Yangshuo Township Hospital, 541900, China

l

State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, China

m

Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510006, China

 

https://doi.org/10.1016/j.phymed.2023.155008

 

 

 

Highlights

 

• •Kumquat decoction was significantly associated with greater improvement in COVID-19-related cough (HR, 1.94; 95% CI, 1.48 to 2.53).
• •Kumquat decoction was associated to a significant reduction of 0.742 days in cough resolution (95% CI: -1.235 to -0.250 days).
• •Similar results were yield in multiple sensitivity analyses.
• •Kumquat decoction is a safe and effective natural remedy for managing cough symptoms.

 

 

 

 

Abstract

Background

Kumquat decoction is a traditional Chinese medicine formula and has been widely used to alleviate the coronavirus disease 2019 (COVID-19)-related cough in China. However, the effectiveness and safety of kumquat decoction remain unclear.

Purpose

To assess the effectiveness and safety of kumquat decoction for COVID-19-related cough.

Study design

A multicentre, prospective observational study.

Methods

We enrolled consecutive patients with mild-to-moderate COVID-19 from December 31, 2022, to January 3, 2023, during the Omicron phase in Yangshuo County, China. The primary outcome was the time from study baseline to sustained cough resolution by the last follow-up day on January 31, 2023. The effectiveness was evaluated by Cox proportional hazards models based on propensity score analyses. The secondary outcomes were the resolution of cough and other COVID-19-related symptoms by Days 3, 5, and 7.

Results

Of 1434 patients, 671 patients were excluded from the analysis of cough resolution. Among the remaining 763 patients, 481 (63.04%) received kumquat decoction, and 282 (36.96%) received usual care. The median age was 38.0 (interquartile range [IQR] 29.0, 50.0) years, and 55.7% were women. During a median follow-up of 7.000 days, 68.2% of patients in the kumquat group achieved sustained cough resolution (93.77 per 1000 person-days) compared to 39.7% in the usual care group (72.94 per 1000 person-days). The differences in restricted mean survival time (RMST) (kumquat decoction minus usual care group) for cough resolution were -0.742 days (95% CI, -1.235 to -0.250, P = 0.003) on Day 7. In the main analysis using propensity-score matching, the adjusted hazard ratio (HR) for cough resolution (kumquat decoction vs. usual care group) was 1.94 (95% CI, 1.48 to 2.53, P < 0.001). Similar findings were found in multiple sensitivity analyses. In addition, the use of kumquat decoction was associated with the resolution of cough, and a stuffy nose on Days 5 and 7, as well as the resolution of sore throat on Day 7 following medication.

Conclusion

In this study among patients with COVID-19-related cough, receiving kumquat decoction was associated with an earlier resolution of cough symptoms.

 

 

Graphical abstract